Key result
Guideline-based treatment experiences of 17 heart failure patients highlighted significant deficits in cross-sector communication and cooperation not fully captured by clinical quality indicators.
Qualitative interviews with heart failure patients reveal that current clinical quality indicators may not adequately capture patient-prioritized needs such as communication and cross-sector care coordination.
Patient perspectives on HF care reveal coordination gaps missed by quality indicators; leaves open how to incorporate them into metrics.
BACKGROUND: The German National Disease Management Guideline (NDMG) on chronic heart failure (CHF) derived nine clinical quality indicators (QIs) to enable assessment of quality of health care in patients with CHF. These QIs epitomize an evidence-based and somatic point of view of guided treatment, but little is known about the experiences and views of patients with their guideline-based treatment across multiple health care sectors. OBJECTIVE: The purpose of this qualitative study was to explore patient perspectives on guided treatment of CHF across multiple health care sectors. Furthermore, it was investigated to what extent patient perspectives are represented by the QIs of the German NDMG. METHODS: Using a qualitative approach, semistructured interviews were carried out with 17 CHF patients. Interviews were audio-recorded and transcribed verbatim. Data were analyzed using qualitative content analysis. RESULTS: Patient-identified needs focused primarily on aspects like the doctor-patient relationship, communication, quality of individual-tailored information, and professional advice. Patients perceived shortcomings in processes of care such as communication and cooperation across health care sectors, especially at the transition between hospital and outpatient care. DISCUSSION: From the patient perspectives, the QIs do represent relevant somatic and clinical aims for quality measurement. However, deficits were identified, especially related to communication and cooperation across health care sectors. Given the fact that the inclusion of patient perspectives in quality improvement processes provides an important contribution to patient-centered health care, possible approaches for QI development such as direct and indirect patient involvement or generic vs disease-specific patient-related QIs should be the subject of future discussions.
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Joos et al. (2015) studied Chronic heart failure (n=17). Guideline-based treatment was evaluated on Patient perspectives on guided treatment of CHF across multiple health care sectors. Guideline-based treatment experiences of 17 heart failure patients highlighted significant deficits in cross-sector communication and cooperation not fully captured by clinical quality indicators.
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